Comparing retrospective reports to real-time/real-place mobile assessments in individuals with schizophrenia and a nonclinical comparison group

Abstract

Retrospective reports are often used as the primary source of information for important diagnostic decisions, treatment, and clinical research. Whether such reports accurately represent individuals' past experiences in the context of a serious mental illness such as schizophrenia is unclear. In the current study, 24 individuals with schizophrenia and 26 nonclinical participants used a mobile device to complete multiple real-time/real-place assessments daily, over 7 consecutive days. At the end of the week, participants were also asked to provide a retrospective report summarizing the same period. Comparison of the data captured by the 2 methods showed that participants from both groups retrospectively overestimated the intensity of negative and positive daily experiences. In the clinical group, overestimations for affect were greater than for psychotic symptoms, which were relatively comparable to their retrospective reports. In both samples, retrospective reports were more closely associated with the week's average than the most intense or most recent ratings captured with a mobile device. Multilevel modeling revealed that much of the variability in weekly assessments was not explained by between-person differences and could not be captured by a single retrospective estimate. Based on the findings of this study, clinicians and researchers should be aware that while retrospective summary reports of the severity of certain symptoms compare relatively well with average momentary ratings, they are limited in their ability to capture variability in one's affective or psychotic experiences over time.

Fig. 1.

Effect sizes (Cohen’s d) for the difference between retrospective and mean experience sampling method (ESM) ratings for affect and symptoms of psychosis. Retrospective and mean ESM ratings significantly different within group (paired t test): ^aP < .05, ^bP < .01, ^cP < .001.

Fig. 2.

Correlations of retrospective ratings with peak experience sampling method (ESM), mean ESM, and end ESM for each affect item in the comparison group; demonstrates the generally higher association with mean ESM.

Fig. 3.

Correlations of retrospective ratings with peak experience sampling method (ESM), mean ESM, and end ESM for each affect/symptom item in the clinical group; demonstrates the generally higher association with mean ESM.